For the Irish government, the timing couldn’t be worse. In the middle of a tense referendum campaign on the legalisation of abortion, it has had to open an official inquiry into an extraordinary breach of trust in the state’s handling of women’s healthcare.

As so often in these cases, the astute inquiries of one individual have unravelled a national calamity. Vicky Phelan, a terminally ill 43-year-old woman who was diagnosed with cervical cancer in 2014, questioned why a smear test in 2011 had given her the all-clear. Abnormalities were detected in a test three years later, but she wasn’t told about them until 2017, by which time the disease was advanced. She sued the US lab to which the test had been outsourced by the Irish screening service.

Phelan is not alone – 208 other women had abnormalities that were detected only after tests were audited, and the information was withheld in 162 of those cases. Seventeen women have since died, 15 of whom were not informed about abnormalities in their tests.

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The numbers keep growing. At least 1,500 more women who were diagnosed with cervical cancer in recent years did not have their smear test results reviewed by the national screening service to determine if their disease could have been flagged up sooner. As a result of the scandal, a team of cytologists from the Royal College of Obstetricians and Gynaecologists in the UK will now review the screening history of every woman who has had a cervical cancer diagnosis in Ireland since screening began in 2008.

Of the women invited to undergo smear tests every year by Ireland’s national screening service, 270,000 take part – an 80% take-up. To examine smear tests, the Irish Health Service Executive (HSE) has been using two US companies, with one laboratory in the US and one in Ireland.

The damage done to confidence in the screening service by the fallout from the Vicky Phelan case is massive, with many women now worriedly revisiting the results of their tests, scared of false negatives. The Labour politician Alan Kelly warned fellow members of parliament that the Irish public viewed the episode as “one big, massive cover-up”.

Another day and another gallop into the Dáil to agonise over this state’s disordered relationship with women

Adding insult to injury, a helpline established last weekend suffered a technical glitch, “The last thing anyone needed, I know,” the health minister Simon Harris tweeted.

The drama has played out in real time through the media. Phelan was on an Irish television talkshow when news broke that Gráinne Flannelly, director of CervicalCheck, had resigned. Now there are calls for Tony O’Brien, chief of the HSE, to follow suit. It emerged this week that he joined the board of a US contraceptives manufacturer earlier this year. He has now taken leave from that role but has resisted pressure to resign from the health service, saying he regarded the crisis as “a personal blow”.

Public anger is compounded by an atmosphere of heightened tension as women’s health and reproductive healthcare is being debated hourly, in the media and on the doorsteps, ahead of the vote to legalise abortion on 25 May.

Beneath all of this is a simmering rage at the evidence that women’s healthcare is treated in a cavalier manner. News that thousands of women in the UK may have missed out on breast cancer screenings they were entitled to has not gone unnoticed. Why, some wonder, do these healthcare mistakes seem to disproportionally involve women. Journalist Miriam Lord eviscerated Ireland’s paternalistic and patriarchal political and medical culture on Wednesday. “Another day in the Dáil and another gallop of TDs into the chamber to agonise over the latest sorry episode concerning this state’s disordered relationship with women from the waist down,” she wrote in the Irish Times.

Sinn Féin’s spokesperson on health, Louise O’Reilly, told the Irish parliament: “The toxic culture of concealment and harassment pursued by the HSE and government against women who have been wronged by the state is now in full public view”. Indeed it is. Again.